Controversy, intolerance, non-adherence and other annoyances around the prescription of statins? How to cope?

Olivier S. Descamps Published in the journal : November 2016 Category : GRAPA

Summary :

In recent years, prescription of antilipemic drugs, particularly statins, has been marked by various controversies, calling into question the patients' beliefs as to the rationale, efficacy, and usefulness of these treatments. Doctors also face regular complaints from their patients, especially of the musculo-articular type, which the patients tend to assign too readily to their statin treatment. As a result, over the past years, there has been a growing number of patients who abandon their antilipemic treatment, at times without medical advice. The adverse reactions caused by the drugs, along with the implementation of such beliefs, are rather challenging to the doctor, and this to such an extent that some physicians feel that, nowadays, it takes courage to prescribe a statin therapy, while being confronted to this public counter belief. This article attempts to address these issues, while providing a reply to the most-commonly raised accusations.

What is already known about the topic?

- The recommendations published by the European societies of Cardiology (ESC) and Atherosclerosis (EAS) are based on evidence-based medicine, advising us to prescribe a statin as first-line treatment, after dietary corrections, in order to correct patients' LDL-cholesterol levels and significantly reduce their cardiovascular risk.
- To the standard obstacles encountered in cardiovascular prevention has recently been added the over-hyping of statins' musculoskeletal adverse effects, as well as hostile polemics questioning the justification, safety, and usefulness of these drugs.

What does this article bring up for us?

This article details a few management strategies aimed to resolve the adherence problems caused by undesirable events, whether or not statin-related, and the doubts of the patients, confronted with such controversies.

Key Words

Cardiovascular disease, cardiovascular prevention, cholesterol, atherosclerosis, drug intolerance, side effects, adherence, medias